CALA News & Views | Issue 46 | Relationships

Clarify Expectations It is essential to set clear expectations early on and avoid relying solely on written policies or residency agreements. Regular conversations with family members can help build trusting relationships and avoid communication challenges.

Once you recognize these dialogue barriers, you can stop the conversation and bring it back to a place of common ground. One example includes talking to a family member who is angry because you are encouraging her to support a move to a memory care program.

She is yelling at you that “If you just did your job, we wouldn’t even be having this conversation.” Remember, this isn’t about you, and it isn’t about you being right or wrong. The daughter is in violence mode, which is a dialogue stopper. If you bring it back to the agreed upon common ground which is “we both want the same thing for your mom; and we want your mom to live in a place where she can feel safe and can participate in the daily programs,” then you can move back into dialogue stating the facts.

Every Executive Director knows that when we welcome a resident into our community, we also welcome their family members. Sometimes, the expectations of family members and resident are not aligned, and sometimes they do not have a clear idea of what the benefits and limitations are. The senior living experience is often new to them. One of my favorite questions to ask family members is, “What does quality care look like to you?” If a family member says, “I want my mom to be happy and live here the rest of her

Regular conversations with family members can help build trusting relationships and avoid communication challenges.

The facts being that she isn’t participating in activities even when she is escorted to them; refuses to come to the dining room; and yesterday was in the parking lot looking for her car. Tell the family member that we are worried about her and want to partner to find a solution. Show empathy and encourage the family member to share her perspective while you listen. One note about facts is that they must be true and consistent. There are times when the leadership team discusses situations with family members and then family members check in with the care team who share differing information. It is important that all team members have access to the factual information and that messages to family members are consistent. Check for Understanding The next steps should be measurable, time bound and reasonable to accomplish. Confusing technical terms, threats, and words such as “never” or “always” are usually not helpful. It can be beneficial to break big challenges into smaller parts and recognize that it may take several conversations and time to work through them all. Of course, this assumes there are no immediate safety or security risks. After the next steps are stated, check for understanding, show empathy and gratitude, and schedule a follow-up to continue the dialogue. In summary, be patient and empathic while clarifying expectations, finding common ground, and checking for understanding. Following these tips can improve communication with family members and lead to positive outcomes for all involved. Paula Hertel has spent 30 years focusing on improving service delivery systems for the elderly while in executive management positions with consulting projects throughout the U.S. She has a proven track record in senior housing and assisted living operations, staff training, regulatory compliance, and new program development. She can be reached at Paula.Hertel@ unwiredltd.com .

life” or “I don’t want her to fall and end up in the hospital” this is an opening to talk about how we want to welcome her and her mom into the community. However, we do not promise daily happiness or that someone is never going to fall. Nor can we promise that every resident can live here forever. Having these types of open conversations and describing how the team partners with residents and families to build community, while not over promising, can begin to build a model for healthy dialogue. Find Common Ground Finding common ground and using open-ended questions can help keep the conversation moving toward a shared outcome. Family members feel valued when they know others are really listening to them. Could we be missing something? Are there other strategies we could try? Listening with an open mind can keep the dialogue open. Questions that start with “Why” or “Tell me more” can prompt answers that lead to a deeper understanding of differing perspectives. In difficult situations we can find ourselves being defensive or wanting to prove we are right. It is hard to find common ground in these situations. We need to own our triggers. Stepping back and remembering that this isn’t a personal attack may help to keep the dialogue moving forward. In the book, Crucial Conversations by Patterson et al, the authors talk about communication styles under stress. They define two common ineffective communication styles as silence or violence modes. People who enter silence mode can withdraw or withhold information, avoid the conversation altogether, or mask their opinions by using sarcasm, mocking others or rationalizing the situation. People who enter the violence communication mode can try to over control the conversation by persuading people to take their side or talking over people, labeling people or ideas in a derogatory way or attacking, which usually leads to making it personal versus factual.

CALA NEWS & VIEWS I ISSUE 46 | APRIL 2023

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